Provider Demographics
NPI:1902507320
Name:ONE BODY PHYSICAL THERAPY & SPORTS MEDICINE
Entity Type:Organization
Organization Name:ONE BODY PHYSICAL THERAPY & SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:AMICONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:740-487-4739
Mailing Address - Street 1:310 SUNRISE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-4662
Mailing Address - Country:US
Mailing Address - Phone:740-487-4739
Mailing Address - Fax:740-487-4739
Practice Address - Street 1:310 SUNRISE CENTER DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-4662
Practice Address - Country:US
Practice Address - Phone:740-487-4739
Practice Address - Fax:740-487-4739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy